Rashtriya Bal Swasthya Karyakram (RBSK)
Health initiative named as “Rashtriya Bal Swasthya Karyakram” was launched by UPA Government in February 2013. It is technically called as ‘Child Health Screening and Early Intervention Services’. This programme has been launched under National Rural Health Mission initiated by the Ministry of Health and Family Welfare. The scheme aims at early detection and management of the 4’D’s prevalent in children.These include:
- Defects at Birth
- Diseases in Children
- Deficiency conditions
- Developmental Delays including Disabilities.
This initiative is taken into action to provide comprehensive healthcare and improve the quality of life of children through early detection of birth defects, diseases, deficiencies and development delays including disability. Rashtriya Bal Swasthya Karyakram aims at screening over 27 Crore children from 0 to 18 years of age for 4’D’s. Children diagnosed with any of the illnesses will receive treatment including surgeries at tertiary level at free-of-cost under NRHM.
The scheme possesses these salient features:
- The programme is extended to cover all districts of the country in a phased manner, with a target to cover over 27 crore children.
- Under this scheme, the children will be screened for 30 common health conditions, so as to ensure possibility of early medical intervention, in case there is a need.
- Birth defects like Down syndrome, congenital cataract, deafness and heart defect, deficiency conditions like anaemia, malnutrition and goitre, developmental delays and disabilities like hearing impairment and vision impairment are the conditions for which children will be screened.
- Mobile health teams will be hired for the screening of children, and two AYUSH doctors (one male and one female), nurse and a pharmacist would be available for the service in every block.
- All children ranging between 0-6 years of age will be enrolled in anganwadis would be screened at least twice a year; all children in government schools and in schools aided by the government would also be regularly screened for the above mentioned conditions.
- Newborn children will also be screened for possible birth defects in health centers where deliveries take place.
- Children with deficiencies, disabilities or diseases would be referred to higher centres for further investigation and treatment if required.
Target Age Group
The services under this scheme aim to cover children of 0-6 years of age in rural areas and urban slums in addition to children enrolled in classes 1st to 12th in Government and Government aided Schools. It is to ensure that these services will reach to about 27 crores children in a phased manner. The broad category of age group and estimated beneficiary is shown in the table below. The children have been grouped in to three categories owing to the fact that different sets of tools would be used for different sets of children and also different set of conditions could be prioritized.
Health Conditions to be Screened
Child Health Screening and Early Intervention Services under RBSK covers 30 selected health conditions for screening, early detection and free management. States and Union Territories may also include diseases namely hypothyroidism, Sickle cell anemia and Beta Thalassemia based on epidemiological situation and availability of testing and specialized support facilities.
Defects at Birth
- Neural tube defect
- Down’s Syndrome
- Cleft Lip & Palate / Cleft palate alone
- Talipes (club foot)
- Developmental dysplasia of the hip
- Congenital cataract
- Congenital deafness
- Congenital heart diseases
- Retinopathy of Prematurity
- Anaemia especially Severe anaemia
- Vitamin A deficiency (Bitot spot)
- Vitamin D Deficiency, (Rickets)
- Severe Acute Malnutrition
Diseases of Childhood
- Skin conditions (Scabies, fungal infection and Eczema)
- Otitis Media
- Rheumatic heart disease
- Reactive airway disease
- .Dental conditions
- Convulsive disorders
Developmental delays and Disabilities
- Vision Impairment
- Hearing Impairment
- Neuro-motor Impairment
- Motor delay
- Cognitive delay
- Language delay
- Behavior disorder (Autism)
- Learning disorder
- Attention deficit hyperactivity disorder
Mechanisms for screening at Community & Facility level
Child screening under RBSK is carried out at two levels — community level and facility level. The Community level screening will be conducted by the Mobile health teams at Anganwadi Centres, Government Schools and Government Aided Schools. While Facility based screening is done at public health facilities centres like PHCs / CHCs/ DH, by existing health manpower like Medical Officers, Staff Nurses & ANMs.
- Paramparagat Krishi Vikas Scheme
- Pradhan Mantri Ujjwala Yojana
- Modi Sagar Mala Yojana
- One Rank One Pension Yojana
Screening at Anganwadi Centre
All children enrolled at pre-school and are of below 6 years of age would be screened by Mobile Block Health teams for deficiencies, diseases, developmental delays including disability at the Anganwadi centre at least twice a year. Tools for screening for 0-6 years children is supported by pictorial job aids specifically for developmental delays. For those suspected would be referred to DEIC for further management and treatment.
Screening at Schools- Government and Government Aided
School children ranging from age 6 to 18 years would be screened by Mobile Health teams for deficiencies, diseases, developmental delays including disability, adolescent health at the local schools for at least once a year. The tools used are questionnaires (preferably translated to local or regional language) and clinical examination.